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Rehabilitation Practice and Science

Translated Title

悠樂手和彈性繃帶對中風病人執行上肢被動運動的手溫和心跳變異率之影響

Abstract

Therapeutic exercise can mitigate sensorimotor deficit and improve motor function in the upper limbs of stroke patients. During physical rehabilitation, elastic bandages (EB) are often used to secure stroke patients' affected upper limbs to exercise equipment. However, the application of EB can reduce blood flow and lower skin temperature in patients' hands. Furthermore, reduced skin temperature can lead to autonomic nervous reactions, of which heart rate variability (HRV) is an effective indicator. This study investigates the correlation between hand temperature and HRV. Stroke patients' hand temperatures and HRVs were documented during passive upper limb exercises, and the results between the use of Yole Hands (YH) and EB were compared. A satisfaction questionnaire was administered immediately following every exercise. Hand temperatures and HRVs were recorded at the beginning, throughout the 15-minute exercise, and 5 minutes after completing the exercise. Paired t-tests were used to compare the changes in hand temperature. Pearson's correlations were used to analyze the correlations between hand temperature and HRV (low frequency, LF; high frequency, HF; LF/HF). With both EB and YH, sympathetic nervous system reactions (LF) were activated during the initial stages of exercise. However, the average temperatures in the patients' affected hands were lower when secured with EB than when secured with YH during the exercises (31.62℃ vs. 33.34℃, p＜0.0001). With the use of EB, the temperatures in the patients' affected hands negatively correlated with LF (r= -0.28). With the use of YH, there was a significant negative correlation between the temperatures in patients' affected hands and LF (r= -0.48, p=0.04). Using EB to secure patients' affected hands impeded blood circulation and resulted in an overactive sympathetic nervous system in the later stages of exercise. With the use of EB, the temperatures in the patients' affected and un-affected hands exhibited significant negative correlation with LF (r=-0.47, -0.57, p=0.049, 0.014). When using EB, the sympathetic nerves were continuously activated, and the parasympathetic nervous system in the unaffected hand was activated as a balanced compensatory reaction after completing the exercises. During recovery, the temperatures in EB patients' affected hands exhibited positive correlation with LF and LF/HF, respectively, (r=0.03, 0.02; p=0.69, 0.79). However, the temperatures in EB patients' unaffected hands correlated very positively with HF (r=0.19, p=0.01). In contrast, with the use of YH, the temperature recovery of both the patients' affected (33.89℃) and unaffected (33.41℃) hands negatively correlated with LF/HF (r=-0.13, -0.19; p= 0.18, 0.01). Patients' feeling of cold hands was less pronounced with the use of YH than with EB (p=0.02). Securing the stroke patients' affected upper limbs to exercise equipment with YH reduced the variation in their skin temperature and autonomic nervous reaction. Therefore, YH is more suitable for application as an assistive device.

Language

Traditional Chinese

First Page

81

Last Page

89

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